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Kaylin Dong, Ashank Bains, Samaneh Davoudi, Anh Hong Nguyen, Xuejing Chen; Evaluation of factors affecting visit adherence in patients receiving intravitreal injections for neovascular age-related macular degeneration during the COVID-19 Pandemic. Invest. Ophthalmol. Vis. Sci. 2022;63(7):331 – F0162.
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© ARVO (1962-2015); The Authors (2016-present)
The COVID-19 Pandemic has disrupted the care of patients receiving intravitreal injections for neovascular age-related macular degeneration (nAMD). This study looks at the factors that affected visit adherence for this population of patients during the height of the first pandemic surge.
In this retrospective, observational, case-control study, we included nAMD patients receiving anti-VEGF injections with an appointment scheduled during the target periods of March 11, 2020 – May 26, 2020 at either an urban hospital-based or suburban eye clinic. Patients who did not present for their appointment (cases) were compared to patients who did present to their appointment (controls). Medical records were reviewed to collect age, sex, race, presence of appointment attendance, language, marital status, distance from clinic, and area of deprivation index (ADI), which is a measure of socioeconomic health. Multivariate regression models were created with Stata (College Station, Texas) to determine the differences of these factors between no-show and show groups.
115 no-show patients (21% male, mean age 81 years) and 129 controls (26 % male, mean age 80.9 years) were enrolled. The odds of no-show were higher in non-White patients compared to White [(odds ratio (OR) = 2.7, 95% Confidence Interval (CI) = 1.22-6.17, P = 0.01)], the urban site compared to suburban site (OR = 3.1, 95% CI = 1.70-5.76, P = 0.0001) and single patients compared to married (OR = 2.3, 95% CI = 1.09-4.89, P = 0.02) in univariate analysis. The associations remained significant in multivariate analysis for non-White patients (OR = 3.1, 95% CI = 1.30-6.88, P = 0.01) and urban site (OR = 4.3, 95% CI = 1.78-10.3, P = 0.001) after adjusting for age, gender, language, distance from clinic and ADI. Age, distance from clinic, gender, ADI, and language were not statistically different between the two groups.
Visit adherence was lower for non-White patients during the first surge of the COVID-19 pandemic underlying the disparities which can be seen during the pandemic. Patients treated at an urban hospital were less likely to present for their anti-VEGF treatments than those receiving care in a suburban clinic. Further research is needed to determine whether differences in visit adherence effected long-term vision outcomes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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